Tatrow, K., & Montgomery, G.H. (2006). Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: A meta-analysis. Journal of Behavioral Medicine, 29(1), 17–27.doi: 10.1007/s10865-005-9036-1
To determine effectiveness of cognitive behavioral therapy (CBT) techniques in alleviating distress and pain in patients with breast cancer
The search retrieved 61 studies. Investigators eliminated some on the basis of the exclusion criterion; meta-analysis involved 20 studies. Authors defined CBT very broadly: Interventions included relaxation; guided imagery; hypnosis; biofeedback; and approaches combining cognitive restructuring, skill trainingt, and other strategies to enhance problem solving and coping. Authors do not describe the specific procedure used to evaluate study quality.
Authors noted that 69% of patients in treatment groups did better than controls with respect to pain. Regarding pain, effect size (d) was 0.49 (95% CI 0.09–0.90, p < 0.05). Subgroup analysis comparing individual versus group interventions showed that intervention format had no effect on pain.
Findings suggest that CBT techniques produced a small to medium effect, as defined by the study, regarding the reduction of the pain of women with breast cancer.
Findings suggest that, for women with breast cancer, CBT may be a helpful adjunct to pain management. This finding is limited by the broad definition of CBT that this study employed. This study determined effect size on the basis of statistics. Future studies should define the type of change that is meaningful to patients—that is, change in symptoms.